Shingles is a painful, itchy rash that develops on one side of the body that can last up to four weeks. It is caused by a reactivation of the varicella zoster virus, the same virus that causes the chickenpox. A third of Americans will develop shingles in their lifetime, with the risk increasing to half of adults over 85, according to the Centers for Disease Control and Prevention. A new vaccine, Shingrix, was recently approved by the FDA and will change the way the medical community prevents the disease. The Advisory Committee on Immunization Practices recently recommended that adults who received the older shingles vaccine, Zostavax, be revaccinated with Shingrix. Zostavax was originally recommended for people 60 and older to prevent shingles and until now was the only vaccine available.

There are several notable differences between Zostavax and Shingrix. Zostavax is a live-attenuated vaccine, meaning it introduces a weaker version of the virus in order to stimulate the immune system to create antibodies to fight against the zoster virus. By contrast, Shingrix is a non-live subunit vaccine that introduces only a piece of the microbe to stimulate the immune system. The thought is that using only a part of the pathogen rather than the whole will reduce the incidence of the body having an adverse reaction. This also allows people with a weakened immune system to receive the Shingrix vaccine.

A second difference is the vaccination age. The CDC suggests Zostavax be taken after the age of 60 while Shingrix is recommended for everyone over 50, including those who have already received a vaccination with Zostavax. Additionally, Zostavax is given as a one-time dose while Shingrix is given in two doses with an interval of 2 to 6 months.

The effectiveness of the vaccine also differs between the two products. Zostavax is 51% effective against shingles and 67% effective against postherpetic neuralgia, a long-term complication of the zoster virus causing nerve pain. In contrast, Shingrix is 97% effective against shingles for people aged 50 to 59 and 91% effective for people over 70. It is also 91% effective against postherpetic neuralgia. However, both vaccines lose effectiveness over time. Zostavax loses 15%-25% effectiveness within the first year and shows no significant protection by year nine while Shingrix remains 85% effectiveness up to 4 years after vaccination.

The side effects of Shingrix are similar to Zostavax but have been shown to be more frequent with Shingirx. These adverse effects fatigue, muscle ache, headache, fever, GI distress, and injection site reaction are the most common and typically last less than a day or two.

Shingrix has cost of about $280 for the two shots but is not likely to be covered by insurance right away. However, it is anticipated that private insurers are likely to cover the cost, as they generally do with Zostavax which costs about $213. This coverage should occur by early next year for private insurance, but Medicare may take a little longer. What’s probable is that Shingrix will be covered under Medicare Part D for those eligible patients, similar to the current treatment of Zostavax by Medicare.

Patients are encouraged to talk to their healthcare provider to see whether this new vaccine is right for them.

DISCLAIMER: The information contained in this article is intended solely for the general information for the reader and is not intended to be a substitute for professional medical advice, diagnose health problems or suggest any treatment. It is not a substitute for medical care provided by a licensed and qualified health professional and does not create a physician-patient or pharmacist-patient relationship. Please consult your health care provider for any personal medical advice.